Early volumetric change and treatment outcome of metastatic brain tumors after external beam radiotherapy

Differential radiotherapy for brain metastasis

D. S. Lee, Y. S. Kim, C. G. Lee, J. H. Lim, Chang-Ok Suh, H. J. Kim, Jaeho Cho

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. Methods: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD1.8Gy) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. Results: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 %, respectively. The 6-month actuarial local control (LC) rate was 93.4 %. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 % after RT, CR rate, if the target was more than 1 cm in size, was 25 % with a median NTD1.8Gy of 45 Gy, requiring dose escalation to achieve better target regression. Conclusions: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.

Original languageEnglish
Pages (from-to)889-896
Number of pages8
JournalClinical and Translational Oncology
Volume15
Issue number11
DOIs
Publication statusPublished - 2013 Nov 1

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Brain Neoplasms
Radiotherapy
Neoplasm Metastasis
Brain
Neoplasms
Histology
Tomography
Magnetic Resonance Imaging
Radiation

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

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title = "Early volumetric change and treatment outcome of metastatic brain tumors after external beam radiotherapy: Differential radiotherapy for brain metastasis",
abstract = "Purpose: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. Methods: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD1.8Gy) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. Results: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 {\%}, respectively. The 6-month actuarial local control (LC) rate was 93.4 {\%}. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 {\%} after RT, CR rate, if the target was more than 1 cm in size, was 25 {\%} with a median NTD1.8Gy of 45 Gy, requiring dose escalation to achieve better target regression. Conclusions: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.",
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Early volumetric change and treatment outcome of metastatic brain tumors after external beam radiotherapy : Differential radiotherapy for brain metastasis. / Lee, D. S.; Kim, Y. S.; Lee, C. G.; Lim, J. H.; Suh, Chang-Ok; Kim, H. J.; Cho, Jaeho.

In: Clinical and Translational Oncology, Vol. 15, No. 11, 01.11.2013, p. 889-896.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early volumetric change and treatment outcome of metastatic brain tumors after external beam radiotherapy

T2 - Differential radiotherapy for brain metastasis

AU - Lee, D. S.

AU - Kim, Y. S.

AU - Lee, C. G.

AU - Lim, J. H.

AU - Suh, Chang-Ok

AU - Kim, H. J.

AU - Cho, Jaeho

PY - 2013/11/1

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N2 - Purpose: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. Methods: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD1.8Gy) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. Results: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 %, respectively. The 6-month actuarial local control (LC) rate was 93.4 %. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 % after RT, CR rate, if the target was more than 1 cm in size, was 25 % with a median NTD1.8Gy of 45 Gy, requiring dose escalation to achieve better target regression. Conclusions: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.

AB - Purpose: To evaluate the treatment outcomes of low-dose whole brain radiation therapy (WBRT)-based differential radiation therapy (RT) for metastatic brain tumors. Methods: A total of 242 targets (metastatic brain lesions) were analyzed in the present study. Median WBRT dose and number of fractions were 25 (range 25-35) Gy and 10 (range 8-15) fractions, respectively. A median normalized total dose (NTD) of 1.8 Gy (NTD1.8Gy) to the metastatic lesion was 45 (range 27-64.8) Gy. We numbered and contoured each metastatic lesion sequentially using computed tomography fused with serial magnetic resonance imaging to evaluate volumetric changes. Results: The 6-month and 1-year freedom from remote intracranial failure rates were 87.7 and 58.5 %, respectively. The 6-month actuarial local control (LC) rate was 93.4 %. Tumor diameter was a major determinant for LC, and tumor histology was a significant parameter predicting the volume reduction rate. With overall complete response (CR) rate of 56.6 % after RT, CR rate, if the target was more than 1 cm in size, was 25 % with a median NTD1.8Gy of 45 Gy, requiring dose escalation to achieve better target regression. Conclusions: Low-dose WBRT with selective boost was feasible and effective. Our results pose the rationale of future trial of differential radiation therapy (RT), which prescribes different radiation dose according to the tumor density in metastatic brain tumors.

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